title: [Efficacy and safety of rivastigmine (exelon) in the confusion syndrome in the acute phase of ischemic stroke].
abstract: There is ample evidence that the poststroke confusion syndrome or delirium is a manifestation of cholinergic deficit. Given this conception, we conducted a controlled study of efficacy and safety of acetylcholinesterase inhibitor rivastigmine in patients developed a delirium in the acute phase of ischemic stroke. The study included 224 consecutive stroke patients: 68 patients developed a delirium in the acute phase of disease. Severity of delirium was scored with the Delirium Rating Scale (DRS). A main group included 21 patients with delirium treated with rivastigmine in individually tailored doses. A control group included 47 patients with delirium who received only vascular and anticoagulant treatment, i.e. haloperidol. Cognitive functions were tested 3 and 6 months after stroke with the MMSE, the FAB, the Luria 10 point verbal test. The Zarit Burden Interview (ZBI) was used after 3 and 6 months to measure caregiver burden. In patients treated with rivastigmine, the delirium phase was significantly shorter (p<0,001) compared to the control group. In patients without delirium in the acute phase of stroke, the results of neuropsychological study were better (p<0,001) than in patients with delirium. Total ZBI scores were more favorable in the rivastigmine group than in the control one (p<0,05). To the end of the study, 5 patients died in the rivastigmine group, 17 patients in the control group and 3 patients in the group without delirium. Rivastigmine was safe in the acute phase of stroke patients even after the rapid titration.
authors.forename: I V
authors.initials: IV
authors.lastname: Litvineneko
authors.forename: M M
authors.initials: MM
authors.lastname: Odinak
authors.forename: Iu V
authors.initials: IuV
authors.lastname: Khlystov
authors.forename: S V
authors.initials: SV
authors.lastname: Perstnev
authors.forename: B B
authors.initials: BB
authors.lastname: Fedorov
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002800:Cholinesterase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D003221:Confusion / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D048448:Phenylcarbamates / Q000009:adverse effects / Q000627:therapeutic use*; D000068836:Rivastigmine; D020521:Stroke / Q000150:complications* / Q000503:physiopathology; D013577:Syndrome; D016896:Treatment Outcome
chemical_list: D002800:Cholinesterase Inhibitors; D048448:Phenylcarbamates; D000068836:Rivastigmine